A study by Heckman, et al. Fracture healing and bone repair are postnatal processes that mirror many of the ontological events that take place during embryonic development of the skeleton and have been extensively reviewed elsewhere. When uncomplicated by fracture the cysts contain clear serosanguineous fluid surrounded by a fibrous membranous lining. A fracture occurs when force exerted against a bone is stronger than the bone can structurally withstand. Fracture blisters can appear daunting to patients and the inexperienced clinician. fracture proximal to femoral component (Su Type I) ... polyaxial screws allow screws to be directed into best bone before locking into plate, and can avoid femoral component; ... A 72-year-old woman sustains a fall onto her knee three years after an uncomplicated total knee replacement. A Randomized Controlled Trial. The Journal of Pediatrics encourages submissions relating to the scientific and health policy implications of the current COVID-19 pandemic that are specific to infants, children, and adolescents. Without health insurance, non-surgical treatment for a broken leg typically costs up to $2,500 or more for a fracture that requires a cast. Treatment can be either operative or non-operative and is dependent on the type of fracture (as determined by the x-ray). Treatment Options for a Broken Dog Tooth Uncomplicated Crown Fracture. The wrist and thumb are immobilized in a short arm thumb spica cast until the fracture is healed. The fracture pattern is seen in Figure A. The majority of uncomplicated middle third fractures will have excellent functional and cosmetic outcomes. Complications take longer. A radiograph taken 6 weeks after surgery and before the fall is shown in Figure 10a. May be seen in younger patients due to long term corticosteroid use, alcohol consumption or malnutrition. Non displaced fractures with a barely visible crack can heal in 6-8 wks in cast. Symptoms may include bleeding, swelling, bruising, and an inability to breathe through the nose. When a fracture involves the knobby end portions of bones that are part of the hip, knee and ankle joints, the fracture is more complicated. Bone is a common metastatic site accounting for cancer-related pain (1,2).Radiation therapy (RT) is a well-accepted treatment for painful uncomplicated bone metastases ().Many studies have documented the effect of single fraction (SF) and multiple fraction (MF) regiments, with the majority of them concluding that the SFRT was equally as effective as MFRT for pain relief (4-20). ICD-10-CM Diagnosis Code S02.92XB. There may be a decreased ability to move the arm and the person may present holding their elbow. Referral to a hand specialist is required if a fracture is unstable, involves a large portion (greater than 30 percent) of the intra-articular surface, or has significant rotation. For example, a long-distance runner may have foot pain due to a fracture or a sprain. A fracture with loss of crown substance confined to the enamel. Any cyst in a high stress area, such as the peritrochanteric region of the femur will require open reduction and internal fixation in addition to the definitive treatment described above. This video discusses various approaches and treatment options for bone fractures. PROGNOSIS FOLLOWING FRACTURE TREATMENT. Epidemiology. One such injury is a stress fracture of the bones. Ice your collar bone several times per day for the first 2-4 days to control any pain and swelling you're experiencing. It is common to see stress fractures in the toes, ankle, foot, hip, and tibia. Methods We examined NHS hospital episode statistics for children aged 1 week to 5 years admitted in England 1997–2009) with an intracranial injury (ICI), uncomplicated head injury (no ICI or skull fracture) or a fractured long bone. This causes a spiral fracture of the bone. Single fraction RT schedule, prescribed to the appropriate target volume, is recommended as the standard of care for the treatment of symptomatic and uncomplicated bone metastases [].During the past two decades, multiple randomized controlled trials (RCTs) have demonstrated pain relief equivalency between a single … The fracture includes the enamel, dentin and pulp canal. Bone healing from electrical stimulation has been shown to be faster in patients who have nonunions (non-healing bones) or patients who have fractures that are difficult to heal. a. reversed Colles' fracture b. fracture of the scaphoid bone in the wrist c. fracture of the radial styloid (chauffeur's fracture) d. fracture dislocation of the first metacarpal e. cause of mallet finger . Whether casting or surgery is employed, a scaphoid fracture will take up to 10-12 weeks to fully heal in uncomplicated cases. A subchondral fracture may also be due to chronic low intensity stress. More displaced ones can take 10-12 wks and some never heal without surgery. A leg X-ray costs an average of $210, according to NewChoiceHealth.com, but can cost as much as $1,000 or more at some radiology centers. Orbital floor fracture (blowout fracture) may also occur as a result of the forceful blunt trauma to the eye. 1–5 The recapitulation of these ontological processes is believed to make fracture healing one of the few postnatal processes that is truly regenerative, restoring the … The College of Surgeons of East, Central and Southern Africa (COSECSA) is an independent body that fosters postgraduate education in surgery and provides surgical training throughout East, Central and Southern Africa. Pins or screws may be needed, as well as … An uncomplicated - closed, not angulated, and not malrotated or otherwise displaced - fifth metacarpal fracture can be managed with initial immobilisation with an ulnar gutter splint . During the active phase, the ⦠A Patient's Guide to Femur Fractures. The leg has three bones that can fracture â the femur (the thighbone) and the tibia and fibula in the lower leg. A nasal fracture, commonly referred to as a broken nose, is a fracture of one of the bones of the nose. ... A 78-year-old woman who has a history of an uncomplicated right total hip arthroplasty presents after a fall. is there an accompanying ulnar styloid fracture? Don’t let osteoporosis sneak up on your patients with a vertebral fracture or a hip fracture! The number of fragments. Any cyst in a high stress area, such as the peritrochanteric region of the femur will require open reduction and internal fixation in addition to the definitive treatment described above. ... For a small, uncomplicated blowout fracture that does not affect the movement of your eye, your doctor may prescribe ice packs, decongestants and an antibiotic to prevent infection. Make no bones about your osteoporosis knowledge, from knowing when to screen your patients to selecting a treatment that matches your patient’s lifestyle. 74) Supracondylar fracture of the humerus in a child a. is due to a … C79.51 Secondary Malignant Neoplasm Of Bone C79.52 Secondary Malignant Neoplasm Of Bone Marrow C85.80 ... Uncomplicated F17.200 Nicotine Dependence, Unspecified, Uncomplicated F25.9 Schizoaffective Disorder, Unspecified ... Fracture, Unspecified Site M81.0 Age-Related Osteoporosis Without Current Antenatal care for uncomplicated pregnancies Diabetes in pregnancy Ectopic pregnancy and miscarriage Hypertension in pregnancy Maternal and child nutrition Pregnancy and complex social factors: service provision Twin and triplet pregnancy Genetic conditions 1 If the emergency physician does not provide restorative care and definitive treatment 2 of a fracture and/or dislocation, the preferred means of reporting this … A fracture is a break or a crack in a bone. The bone is merely treated as uncomplicated traumatic fracture, and the fact that the cyst has decompressed itself will hasten its resolution. Think of something hard breaking in a crisp, snapping manner, and you've just imagined a fracture. A fracture of the crown that does not expose the pulp. Recovery times vary from about 3 weeks to 3 months depending upon the individual's elbow usage. Uncomplicated crown-root fracture. I’m Ed Smith, a Sacramento Bone Fracture Lawyer. is there an accompanying ulnar styloid fracture? No need to register, buy now! In vitro and in vivo animal models suggest the beneficial effects of statins through bone formation and modulating proinflammatory cytokines triggered by implant debris. Scans can be expensive, may involve radiation and wonât make you get better any faster, so talk to your doctor about whether you need them. The bone is merely treated as uncomplicated traumatic fracture, and the fact that the cyst has decompressed itself will hasten its resolution. Electrical stimulation has not been shown to be helpful in uncomplicated fracture healing. C79.51 Secondary Malignant Neoplasm Of Bone C79.52 Secondary Malignant Neoplasm Of Bone Marrow C85.80 ... Uncomplicated F17.200 Nicotine Dependence, Unspecified, Uncomplicated F25.9 Schizoaffective Disorder, Unspecified ... Fracture, Unspecified Site ⦠It is thought to arise as a defect during bone growth which fills with fluid, resulting in expansion and thinning of the overlying bone. May be seen in younger patients due to long term corticosteroid use, alcohol consumption or malnutrition. For example, a long-distance runner may have foot pain due to a fracture or a sprain. Shortening a too-long toe or using an appropriate type of bar shoe (such as a three-quarter-bar shoe) can relieve pressure. Provide parent with fracture of the clavicle (collarbone) fact sheet. After desk review, manuscripts related to COVID-19 chosen for peer review will undergo rapid review. For the best chance of uncomplicated bone healing, animals should be confined to a small space at home (cage, small room) until recovery is adequate and follow up xrays show good progression of fracture healing. Enamel fracture. Unspecified fracture of facial bones, initial encounter for open fracture. A skull fracture is a break in one or more of the eight bones that form the cranial portion of the skull, usually occurring as a result of blunt force trauma.If the force of the impact is excessive, the bone may fracture at or near the site of the impact and cause damage to the underlying structures within the skull such as the membranes, blood vessels, and brain. 85 Allogeneic and xenogeneic bone grafts lead to immune responses in the host. In uncomplicated bruises or dry corns, the first step is to relieve pressure on the affected area. The cause of a humerus fracture is usually physical trauma such as a … Uncomplicated crown-root fracture. •A dislocation and fracture of the same bone is coded to the fracture, only. It is thought to arise as a defect during bone growth which fills with fluid, resulting in expansion and thinning of the overlying bone. Complications may include injury to an artery or nerve, and compartment syndrome.. Enamel fracture. Use of these codes is only appropriate if the emergency physician provides "a significant portion of the global fracture care". https://orthoinfo.aaos.org/en/diseases--conditions/fractures-broken-bones Electrical stimulation has not been shown to be helpful in uncomplicated fracture healing. Find the perfect bone fracture healing stock photo. Recovery times vary from about 3 weeks to 3 months depending upon the individual's elbow usage. Upon acceptance, the accepted manuscript will be posted on the journal website. There are three stages to bone healing: reactive stage (a blood clot forms between the two ends of the fracture), repair stage (specialized cells begin to form a callus, which spans the fracture), and remodeling phase (bone is created and the injury is … For example, an isolated fracture, such as a fracture in the shaft of the fibula bone is uncomplicated and complete healing is high. A fracture of the crown and root that does not expose the pulp. Patient is told to rest for some days and avoid blowing the nose and to allow the eye a chance to heal. 4. Complicated crown fracture. To heal from a broken collar bone, it's important to keep your arm supported in a sling for 4-8 weeks. The term is predominantly used in the context of fractures of long bones although other types of bones may have transverse fractures, e.g. Non-Surgical. The Supracondylar fracture of the humerus is a fracture of the distal end of the humerus just above the elbow joint. The location of the fracture dictates restrictions placed on patients, and immobilization. There may be a decreased ability to move the arm and the person may present holding their elbow. In the previous tooth trauma entry we covered: avulsion (when a tooth is out of the socket). 14, 132 Reports in the literature range from uncomplicated incorporation to a considerable complication rate. Complicated crown fracture. For example, an isolated fracture, such as a fracture in the shaft of the fibula bone is uncomplicated and complete healing is high. When uncomplicated by fracture the cysts contain clear serosanguineous fluid surrounded by a fibrous membranous lining. Alternatively, a more minimalistic approach of strapping the little and ring finger together, also known as buddy taping, can be used in uncomplicated cases [12] . transverse fracture of the temporal bone. Tooth fractures are defined as complicated or uncomplicated:1 Uncomplicated crown fractures have direct dentin but no pulp exposure Complicated crown fractures have direct pulp (nerve) exposure. Without health insurance, non-surgical treatment for a broken leg typically costs up to $2,500 or more for a fracture that requires a cast. - Lateral malleolus definition - Imaging pilon fracture of distal tibia - Ankle mortise - Oblique uncomplicated fracture of the lateral malleolus - Isolated fracture of the medial malleolus - Oblique fractures of the lateral and posterior malleoli - Bimalleolar fracture - Unstable lateral malleolar fracture - MRI showing osteochondral injury talus - Bone scan stress fracture distal fibula This is to rule out any potential rare causes, including spinal cancer, bone growths (spurs), fracture or narrowing of spinal canal (stenosis). In this tooth fracture, the damage is limited to the crown of the tooth. Pain from the fracture and restriction of movement are usual for 2-3 weeks and will require regular analgesia. The cause of a humerus fracture is usually physical trauma such as a fall. When a fracture involves the knobby end portions of bones that are part of the hip, knee and ankle joints, the fracture is more complicated. Stress fractures can further be categorized as a fatigue fracture or an insufficiency fracture. x To report a consolidated management protocol for patients with spasm of near reflex (SNR), including classification of cases as mild, … If there is blowout fracture, which is small and uncomplicated, then only ice packs, decongestants and an antibiotic for preventing infection are prescribed. Many individuals wonder: what does a stress fracture feel like? This microscopic break happens when thin cracks form as the answer to repeated pressure on a bone. Non-surgical treatment is possible if the scaphoid fracture maintains proper alignment. This newborn had an uncomplicated vaginal delivery, but on the initial examination, crepitus was appreciated over the left clavicle. Shortening a too-long toe or using an appropriate type of bar shoe (such as a three-quarter-bar shoe) can relieve pressure. Care and observation in uncomplicated cases when the delivery occurs outside a healthcare facility; Type 1 Excludes. The location of the fracture dictates restrictions placed on patients, and immobilization. The leg has three bones that can fracture — the femur (the thighbone) and the tibia and fibula in the lower leg. Posted on Apr 27th, 2017 / Published in: Ankle. PROGNOSIS FOLLOWING FRACTURE TREATMENT Most dogs and cats return to a good level of activity following fracture … The Supracondylar fracture of the humerus is a fracture of the distal end of the humerus just above the elbow joint. Both types require therapy, but treatment differs depending on the physical and radiographic appearance. The fracture site within the bone. Depending on the pathophysiology, involvement of a geneticist for workup and management of a pathologic bone fracture should be considered. However, fracture at the knee and ankle takes longer time to heal and restriction and immobilization are paramount. Most fracture and/or dislocation management codes are surgical "global care" procedures. 3.5% of primary uncemented hip replacements. During the active phase, the cyst remains adjacent to the growth plate. Incidence. Painful uncomplicated bone metastases. uncomplicated bone healing, animals should be confined to a small space at home (cage, small room) until recovery is adequate and follow up x-rays show good progression of fracture healing. Fracture Complications A. uncomplicated B. bone -> nonunion-> malunion C. delayed union D. posttraumatic OA:-> intra-articular or malunion F. pesudoarthrois-> false joint; bursal Open Fracture Complications: 1) pain, pallor, paresthesia, paralysis, pulselessness … The prognosis is good for uncomplicated elbow dislocations treated appropriately. The answer can be a bit complex. Symptoms may include pain, swelling, and bruising. During the active phase, the … They may be complicated by other facial fractures or a septal hematoma.. Uncomplicated crown-root fracture A fracture of the crown and root that does not expose the pulp; Complicated crown-root fracture A fracture of the crown and root that exposes the pulp; Root fracture A fracture involving the tooth root. A sensitivity analysis will be performed. Most uncomplicated fractures may not need all specialties involvements and may not need therapy services. Transverse fractures are complete fractures that traverse the bone perpendicular to the axis of the bone. The average fresh uncomplicated tibial fracture takes 4 months to heal, and a majority of cases of nonunion involve the tibia. The force of the blow pushes the eyeball further into the eye socket, fracturing the very thin walls of bone that make up the eye socket. The most common sites for bone fractures are the wrist, ankle and hip. Answer. This is to rule out any potential rare causes, including spinal cancer, bone growths (spurs), fracture or narrowing of spinal canal (stenosis). Teeth with an uncomplicated crown fracture can be treated by sealing the fracture site. Allogeneic or xenogeneic bone grafts have been used on various occasions either as corticocancellous grafts or as demineralized bone or powder. The location of the fracture dictates restrictions placed on patients, and immobilization. Elbow dislocation complications may involve bone fractures, blood vessel and/or nerve problems, compartment syndrome, and others. 85 Allogeneic and xenogeneic bone grafts lead to immune responses in the host. fracture proximal to femoral component (Su Type I) ... polyaxial screws allow screws to be directed into best bone before locking into plate, and can avoid femoral component; ... A 72-year-old woman sustains a fall onto her knee three years after an uncomplicated total knee replacement. 6 ICD-9-CM Fracture Coding ... –Normal, uncomplicated follow-up care –Application of the first immobilization device, e.g., cast or splint. What to expect during your visit, following an uncomplicated crown fracture: X-Rays will be taken. A fracture of the crown that exposes the pulp. Aims To determine the prevalence of codes related to child maltreatment in hospital administrative records of children with head injury or fracture. Painful uncomplicated bone metastases. In vitro and in vivo animal models suggest the beneficial effects of statins through bone formation and modulating proinflammatory cytokines triggered by implant debris. However, fracture at the knee and ankle takes longer time to heal and restriction and immobilization are paramount. A fracture is a broken bone in the eye socket involving the rim, the floor or both. Understanding more fully their pathogenesis and However, fracture at the knee and ankle takes longer time to heal and restriction and immobilization are paramount. x Statins have a variety of pleiotropic effects that could be beneficial for patients undertaking total knee or hip arthroplasty. Closed fracture reduction Open procedures where there is the possibility of: • bone fragments and/or bone spicules, • mechanical drilling involved • Deep tunnelling using sharp instruments Diagnostic Arthroscopy Endoscopic Carpal tunnel decompression Otolaryngology, head and neck Bony facial reconstructive surgery doi: 10.1016/j.annemergmed.2019.01.032 Treatment and prognosis. Fracture healing and bone repair are postnatal processes that mirror many of the ontological events that take place during embryonic development of the skeleton and have been extensively reviewed elsewhere. care for postpartum complication- see Alphabetic index ... Facial bone fracture; Open fracture of facial bones. Most dogs and cats return to a good level of activity following fracture repair. A humerus fracture is a break of the humerus bone in the upper arm. How much you can expect to pay out of pocket for a broken leg, including what people paid. The goal in treating a tooth trauma case is always to maintain or regain pulpal vitality in the affected tooth/teeth. However, most people with back pain feel better in a month. Antenatal care for uncomplicated pregnancies Diabetes in pregnancy Ectopic pregnancy and miscarriage Hypertension in pregnancy Maternal and child nutrition Pregnancy and complex social factors: service provision Twin and triplet pregnancy Genetic conditions Uncomplicated crown/root fracture = a fracture that involves the crown of the tooth and extends below the gum line to also affect the root of the tooth, with dentin exposure but without pulp exposure. Bone up on osteoporosis in primary care! Treatment and prognosis. Huge collection, amazing choice, 100+ million high quality, affordable RF and RM images. ... For a small, uncomplicated blowout fracture that does not affect the movement of your eye, your doctor may prescribe ice packs, decongestants and an antibiotic to prevent infection. There are three stages to bone healing: reactive stage (a blood clot forms between the two ends of the fracture), repair stage (specialized cells begin to form a callus, which spans the fracture), and remodeling phase (bone is created and the injury is slowly resculpted into its original shape). Strength: Strengthening exercises will help restore the muscle and bone strength lost during immobilization. Complications take longer. Although a classic finding for clavicle fracture, crepitus is not always present. The type of bone. Pathological fractures: fracture in a diseased bone (due to a tumour or infection) Reduced bone mineral density: osteopenia and osteoporosis. Uncomplicated crown fracture. JACS has partnered with COSECSAâs journal, East and Central African Journal of Surgery, to provide mentorship and promote friendship and the exchange of ⦠The College of Surgeons of East, Central and Southern Africa (COSECSA) is an independent body that fosters postgraduate education in surgery and provides surgical training throughout East, Central and Southern Africa. Introduction. The transverse section of the shaft of the humerus is somewhat circular in shape which gets more flattered as it descends down to meet the distal end of the humerus. The fracture pattern is seen in Figure A. In the instance of an uncomplicated crown fracture the first step an individual should try to accomplish is finding the piece of broken tooth. Is Buddy Taping as Effective as Plaster Immobilization for Adults With an Uncomplicated Neck of Fifth Metacarpal Fracture? Complicated crown fracture = fracture limited to the crown of the tooth that does involve pulp exposure. Most fracture and/or dislocation management codes are surgical "global care" procedures. Mouth will be checked for soft tissue lacerations and the presence of any other foreign bodies. Strength: Strengthening exercises will help restore the muscle and bone strength lost during immobilization. A study by Heckman, et al. Experience Overview Patient: Landon Smith Digital Clinical Experience Score 96.6% This score measures The prognosis is good for uncomplicated elbow dislocations treated appropriately. The most common causes include assault, trauma during sports, falls, and motor vehicle collisions. Depends on fracture: Healing time depends on severity and location--how much cracking or separation of the bone ends there is and where in the scaphoid ( distal, waist or proximal pole). The bone scan can help determine if a bone injury or a tendon sprain is the cause of the pain. The transverse section of the shaft of the humerus is somewhat circular in shape which gets more flattered as it descends down to meet the distal end of the humerus. In this entry we will investigate a different kind of tooth trauma: an uncomplicated crown fracture. The word is most often applied to a broken bone, but it can used … The force of the blow pushes the eyeball further into the eye socket, fracturing the very thin walls of bone that make up the eye socket. A skull fracture is a break in one or more of the eight bones that form the cranial portion of the skull, usually occurring as a result of blunt force trauma.If the force of the impact is excessive, the bone may fracture at or near the site of the impact and cause damage to the underlying structures within the skull such as the membranes, blood vessels, and brain. There will be dentin exposed, but no pulp exposure. Fresh fractures are classified based on: 1. They can also be caused by road traffic accidents. This can lead to pinching (entrapment) of the optic nerve and the muscles that move the eye. When uncomplicated by fracture the cysts contain clear serosanguineous fluid surrounded by a fibrous membranous lining. During the first Match Day celebration of its kind, the UCSF School of Medicine class of 2020 logged onto their computers the morning of Friday, March 20 to be greeted by a video from Catherine Lucey, MD, MACP, Executive Vice Dean and Vice Dean for Medical Education. Annals of Emergency Medicine, 74(1), 88–97. Pathological fractures: fracture in a diseased bone (due to a tumour or infection) Reduced bone mineral density: osteopenia and osteoporosis. The patient may be admitted and observed for a short period of time before being discharged home. Complications may include injury to an artery or nerve, and compartment syndrome.. Electrical stimulation has not been shown to be helpful in uncomplicated fracture healing. Closed fracture reduction Open procedures where there is the possibility of: ⢠bone fragments and/or bone spicules, ⢠mechanical drilling involved ⢠Deep tunnelling using sharp instruments Diagnostic Arthroscopy Endoscopic Carpal tunnel decompression Otolaryngology, head and neck Bony facial reconstructive surgery Sacramento Bone Fracture Lawyer. The doctor or staff member will collect the tooth segment from you if you were able to find and preserve it. A fracture of the crown that does not expose the pulp. Uncomplicated crown fracture. A fatigue fracture is due to abnormal stress placed on normal bone, such as training for a marathon. Scar tissue mobility: If you had surgery for your fracture, your physical therapist may use scar mobilization and massage techniques and teach you how to do self-massage at home. Scans can be expensive, may involve radiation and won’t make you get better any faster, so talk to your doctor about whether you need them. Fracture blisters are more formidable in their impact on subsequent treatment options such as surgical incisions or percutaneus fixation once formed than their prognosis in terms of eventual uncomplicated healing. A humerus fracture is a break of the humerus bone in the upper arm. x To report a consolidated management protocol for patients with spasm of near reflex (SNR), including classification of cases as mild, moderate, and severe based on treatment outcomes. Fractures of the heel bone are usually the result of jumping and landing on the heel. The bone scan can help determine if a bone injury or a tendon sprain is the cause of the pain. Elbow dislocation complications may involve bone fractures, blood vessel and/or nerve problems, compartment syndrome, and others. This can lead to pinching (entrapment) of the optic nerve and the muscles that move the eye. Closed hyoid bone fractures are usually uncomplicated and managed conservatively as long as the airway is secure1. For example, an isolated fracture, such as a fracture in the shaft of the fibula bone is uncomplicated and complete healing is high. A fracture of the crown that exposes the pulp. Answer. The pulp canal is now open and exposed and oral bacteria have direct access to the pulp. Introduction. JACS has partnered with COSECSA’s journal, East and Central African Journal of Surgery, to provide mentorship and promote friendship and the … (SAE13HK.10) A healthy, active 72-year-old man tripped and fell, landing on his left hip 10 weeks after an uncomplicated left primary uncemented total hip replacement. A neurologist may be helpful if an underlying neuromuscular condition is suspected. Although a classic finding for clavicle fracture, crepitus is not always present. This newborn had an uncomplicated vaginal delivery, but on the initial examination, crepitus was appreciated over the left clavicle. The average fresh uncomplicated tibial fracture takes 4 months to heal, and a majority of cases of nonunion involve the tibia. Long bone fractures occur commonly in small animals. A fracture is a broken bone in the eye socket involving the rim, the floor or both. Follow up within the next two weeks will usually show recovery of symptoms and a healing hyoid fracture.
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